OP RNTE#112--s- -ej3coz Harnett County Department of Public Health 24321
PERMIT # _2 $7S'7_ Operation Permit
13' New Installation ERleptic Tank E�1.4itrification line ❑ Repair ❑ Expansion
PROPERTY LOLATION "/
Name: (owner) C�9��G L�Dr.,+a o� SUBDIVISION W ( .��(_Gcmf— LOT #
System Installer. TWe a, -I . Registration #
Basement with plumbing: ❑ Garage umber of Bedrooms .3
Type of Water Supp11 Community f Public El Well Distance from well feet
System Type: ZI r"VA jr/j Types V and VI Systems expire in 5 years.
(In accordance with Table V a) 7 Owner toast con�Waat apartment 6 months ri ion for�ermit renewal.
This system has been imuxed in compliance wish applicable North Carolina General (A(/•,.,,,(C,�
PERMIT CONDITIONS
I. Performance:
II. Monitoring:
III. Maintenance:
IV. Operation:
V. Other.
10
System shall perform in accordance with Rule .1961.
As required by Rule .1961.
As required by Rule .1961. Other:
Subsurface system operator required? Yes ❑ No ❑
If yes, see attached sheet for additional operation conditions,
and all conditions of the Improvement Pea?nit and Construction
maintenance and reporting.
❑
D -Box ❑
Pump ❑
Alarm ❑ H2OLine ❑ PWR Line
Following are the
specifications for the sew;g( disposal
system on the above captioned property.
Type of system:
❑ Conventional C� Other 21%
ON CIA— A/2)
Septic Tank 100 O gallons Pump Tank: 1 J 00 gallons
Subsurface
Drainage Field
No. of
ditches
exact length
of each ditch 0 U feet
width of depth of
ditches 3 Feet ditches 14-1%: inch.,
French Drain Required: Linear feet
Authorized State Age Date 11' 22-1 L
-��
pp� �111 N
16-5-3930OR (1) 16-5-3930OR (2) 16-5-3930OR (3) 16-5-3930OR (4) 16-5-3930OR (5)
16-5-3930OR (6) 16-5-39300R (7) 16-5-39300R (8) 16-5-3930OR (9) 16-5-3930OR (10)
Q
16-5-39300R (11) 16-5-3930OR (12) 16-5-3930OR (13) 16.5-39300R (14) 16-5-39300R (15)
16-5-3930OR (16) 16-5-3930OR (17) 16-5-3930OR (18) 16-5-3930OR (19) 16-5-39300R (20)
t;
16-5-39300R (21)